COVID-19 in an international European liver transplant recipient cohort
Top Cited Papers
Open Access
- 22 June 2020
- Vol. 69 (10), 1832-1840
- https://doi.org/10.1136/gutjnl-2020-321923
Abstract
Objective Knowledge on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in liver transplant recipients is lacking, particularly in terms of severity of the disease. The aim of this study was to describe the demographic, baseline clinical characteristics and early outcomes of a European cohort of liver transplant recipients with SARS-CoV-2 infection. Design We conducted an international prospective study across Europe on liver transplant recipients with SARS-CoV-2 infection confirmed by microbiological assay during the first outbreak of COVID-19 pandemic. Baseline characteristics, clinical presentation, management of immunosuppressive therapy and outcomes were collected. Results 57 patients were included (70% male, median (IQR) age at diagnosis 65 (57–70) years). 21 (37%), 32 (56%) and 21 (37%) patients had one cardiovascular disease, arterial hypertension and diabetes mellitus, respectively. The most common symptoms were fever (79%), cough (55%), dyspnoea (46%), fatigue or myalgia (56%) and GI symptoms (33%). Immunosuppression was reduced in 22 recipients (37%) and discontinued in 4 (7%). With this regard, no impact on outcome was observed. Forty-one (72%) subjects were hospitalised and 11 (19%) developed acute respiratory distress syndrome. Overall, we estimated a case fatality rate of 12% (95% CI 5% to 24%), which increased to 17% (95% CI 7% to 32%) among hospitalised patients. Five out of the seven patients who died had a history of cancer. Conclusion In this European multicentre prospective study of liver transplant recipients, COVID-19 was associated with an overall and in-hospital fatality rate of 12% (95% CI 5% to 24%) and 17% (95% CI 7% to 32%), respectively. A history of cancer was more frequent in patients with poorer outcome.Keywords
Funding Information
- Stiftung für die Leberkrankheiten
This publication has 31 references indexed in Scilit:
- Sensitivity of Chest CT for COVID-19: Comparison to RT-PCRRadiology, 2020
- Liver injury during highly pathogenic human coronavirus infectionsLiver International, 2020
- Liver injury in COVID-19: management and challengesThe Lancet Gastroenterology & Hepatology, 2020
- Cancer patients in SARS-CoV-2 infection: a nationwide analysis in ChinaThe Lancet Oncology, 2020
- Clinical features of patients infected with 2019 novel coronavirus in Wuhan, ChinaThe Lancet, 2020
- MERS CoV Infection in Two Renal Transplant Recipients: Case ReportAmerican Journal of Transplantation, 2015
- Acute Respiratory Distress SyndromeJAMA, 2012
- Infection in Solid-Organ Transplant RecipientsThe New England Journal of Medicine, 2007
- Severe Acute Respiratory Syndrome (SARS) in a Liver Transplant Recipient and Guidelines for Donor SARS ScreeningAmerican Journal of Transplantation, 2003
- Late mortality after orthotopic liver transplantationThe American Journal of Surgery, 2001